My Internship

Dr. Amber Comer: Goals of Care Conversation after Severe Stroke:

A Pilot Feasibility Study

Summary

The primary research objective is to determine the prevalence and characteristics associated with having a documented goals of care conversation after a severe stroke, based on the NIHSS stroke scale. Goals of care conversations hold an important role when it comes to effective communication between the patient, the family, and the care team. That is because we want to make sure the stroke patient's values, preferences, or goals are respected. It’s also in an effort to prevent stroke patients from getting unwanted aggressive treatment. As an intern, I work under Dr. Amber Comer Ph.D., J.D. Before we began the actual data collection we had to train and read to inform ourselves about the study. When we were given the “go” to start collecting data, we collected data from stroke patients' charts on RedCap. It's important to have “the talk” with your family members so they are aware of your “ values, preferences, or goals” when it comes to whether you want all the possible treatment or you prefer comfort care.

Learning and Skills

I want to learn how to be more professional and how to approach people who are already in a professional setting. I would also love to learn more about the research that is being done and gain experience in research input. Learning these things in my internship will be helpful in a future career because I will have an idea of how to approach a professional person without being nervous, and I will have an idea/knowledge of how data works and how to input it. Now that the project is slowly starting to come together, as I stated before all the reading and training will come to use. I'm most excited that I will be contributing to the research not just halfway through the research, but from the very beginning. After submitting the evaluation form, some of the skills listed that I've been using are teamwork, independence, work progress as a whole, and communication. I'm confident in things that I know I can control, so working independently, being present and punctual at all meetings. I do need to work on my communication, but only on communicating my question parts. I don't want to feel like I'm overwhelming my team with questions. Sometimes I have to give myself a small pep talk. I'll say it's okay to ask questions and I'm sure they rather I ask my question, than act like I know what I'm doing. And mess up on inputting data or searching for patients. I would like to also continue working on my work progress in general, staying on top of what has to get done for my internship, and making sure I'm using correct tones when emailing or speaking. My internship fits in with what I've been learning in my classes because it's all about the healthcare field. It's a bit of a different aspect since my major is major on the management side, but it still gives you a different perspective. I believe having this different perspective, will be good because I will be able to connect with other people in the hospitals, I will have an understanding of what they do, and acknowledge their work. I don't really think my internship will help me gain a deeper understanding of my classwork, as my internship is more research-based. So what I've been doing lately is looking over patients' files and looking for specific details to see if they fit our requirement to enter the study. So far as an intern I learned how to use RedCap and use excel more proficiently. As I spent a lot of time looking and recording data into an excel sheet. I also learned to ask more questions if I didn't feel comfortable with what I understood. That's something I've struggled with so I do feel like I've gotten better in general. My favorite experience so far is meeting everyone in the research group. It gives a different perspective of things. One skill I have developed is more communication skills. I work with my team and I know communication is key. I also have been exposed more to the Microsoft apps like Microsoft teams and excel. I feel that is important because a lot of facilities are computerizing, so having computer skills is useful. My contributions have made an impact on the study itself because I'm part of the data collection. We are now starting to transcribe interviews that physicians had about their thoughts on the Goals of Care template. Not only does my work count but everyone's work counts for the bigger picture because we are all contributing to eventually getting the data set, and having the final data. Reflecting on the skill I have used this year is communication. I'm still aiming to improve but I feel as if I've been using that skill better and have been asking more questions. To strengthen this skill more, I plan to apply for both summer and fall internships to keep communication and to keep using what I'm constantly learning about effective communication. Though I'm not saying my communication sucks, I'm a strong believer that communication is key. It's more about me using my voice to say what I'm really thinking, and feeling comfortable asking questions. This experience has allowed me to build my skills because I was constantly challenged to do better when collecting data, making sure all data was correct.

So far my internship instructor is starting a new research project, this coming week. All the training I have been doing and reading will finally go into use. We are currently awaiting the lecture video, where my internship instructor presents the no project. Watching that video is important as it contains important information about the study. The study that is about to begin is about stroke patients who have a score greater than 10 on the NIH Stroke Scale. When we find the patients who meet the criteria, physicians are encouraged to use the "Goals Of Care" template. The template is what we want to see if it is effective, by helping both the physician and patient discuss treatment, in case the patient can't make a decision anymore because of their health declining or are unresponsive. When the research starts next week, I will have an assigned date to go into Cerner and check on the prior patients and try to find new patients who meet the criteria. Being that most of my work has been done remotely, it's hard getting professional experience, if I'm not in the office much. Hopefully, once the research starts, I will have the chance to be more active and maybe even interact with patients.

It has been more different compared to when I started. In the beginning, it was mostly all training, and understanding what the research is about. Now I'm actually going through patients' files, I'm recording data. I'm able to identify if the patient meets our criteria or not. Though I don't believe it was different than what I personally expected, because I had never had an internship, and I wasn't sure what to expect from the beginning.

This current experience is way more different than what I had imagined, but honestly, I like it because I can do my work at my own pace.

Successes and challenges

The most successful moment as an intern was finishing the chart sorting I had to do. I felt accomplished because when we first got the assignment, I felt lost at first. I felt behind as if everyone else was understanding the task, but me. I then asked another intern, and they were on the same page as me. I was glad I asked because now we could figure it out together.

The most challenging part is when going through the charts, you have to use your own judgment on what information to record from each chart. So trusting my gut and reading everything make sure you get all the information necessary. I did overcome this challenge, as the more charts I did, I felt more comfortable doing charts. I plan to work on this in the spring by doing more practice charts. What I'm currently trying to do is write things down more instead of just reviewing the chart, because writing it down helps me remember and understand better. What we did as a team was to check each other's charts, to catch any mistakes or typos someone else didn't catch. A new success to wrap up my year would be finishing this internship strong.

Citations for Pictures:

Computer (yellow background) - https://blog.rescuetime.com/work-from-home-productivity-data/

Computer (pink background) - https://www.wbur.org/hereandnow/2021/06/28/quitting-job-advice

Computer (cat) - https://animatedjobs.com/animationjobs/animating-from-home-how-to-adapt-as-the-coronavirus-forces-remote-working/

Excel - https://www.techadvisor.com/how-to/software/microsoft-excel-free-3689600/

Computer with Data - https://luddy.indiana.edu/research/student-research/summer-research.html

Teamwork - https://www.123rf.com/photo_32082221_teamwork-graphic-design-vector-illustration.html